Degenerative Joint Disease Flashcards
When do early degenerative OA changes start
20s
OA risk factors
Obesity
Abnormal mechanical loading
Inherited T2 collagen defects in premature polyarticulad OA
inheritance - nodal and erosive OA
other arthritic conditions
Systemic inflammation
What measurement shows the axis of pull of the quadriceps tendon and the ligament of the patella
Q angle
Normal q angle
15-20*
What landmarks are used to find q angle
ASIS
centre of patella
Tibial tuberosity
Why is a angle greater in women than men
Wider pelvis
Does a greater Q angle put more strain on the medial or lateral compartment of the knee
Medial
Most common 3 comorbid conditions
Joint problems
Cardiometabolic
Mental health
How does obesity increase OA risk
Poor diet - less protective nutrients and more pro inflammatory substances
Incr stress in joints
Incr adipose derived inflammatory mediators
2 types of OA
Primary OA
Secondary OA
Pri OA cause
Idiopathic
Difference between primary and secondary OA
Primary - idiopathic
Secondary - caused by mechanical joint abnormality, inflammatory disease, endocrine disorders,metabolic disorders
Is x ray the best means of assessment or diagnosis of OA
Assessment
4 signs of OA on XR
Joint space narrowing
Osteophytes
Subchondral sclerosis
Subchondral cysts
Trabeculae fractures
LOSSt
What does synovial fluid entering the bone in OA lead to
Trabeculae fractures
Subchondral cysts
Which imaging methods are best for OA diagnosis
MRI
arthroscopy
Ultrasound
How many grades are there of OA
5 (0,1,2,3,4,)
OA grades
0 - normal
1 - bone spur no pain
2 - 1st time symptoms, pain on walking, more spurs
3 - moderate OA, pain + stiffness, cartilage damage
4 - severe OA, dramatic joint space loss, high pain when moving
OA physical signs
Crepitus
Bony enlargements
Deformity
Instability/pseudolaxity
Restricted movement
Effusion
Muscle weakness or wasting
Crepitus
Popping/creaking sound when moving joint from loss of articular cartilage
What causes visible deformity of joints in OA
Osteophytes
Loss of articular cartilage
Pseudolaxity
Narrowed joint space but ligaments still original length so more lax making joint unstable
What causes effusion in OA
Osteophytes irritate synovium
Pro inflammatory cytokines
What nodes form in the DIP and PIP joints in nodal generalised OA
DIP - herberdens node
PIP - Bouchards node
Which joints are effected by nodal generalised OA
Small joints of hands
Erosive OA is a severe subset of what type of OA
Nodal generalised OA
Hand deformities caused by erosive RA
Gull wing deformity
Sawtooth deformity
Erosions in centre and edges of PIP and DIPs
What causes full wing and saw tooth deformities
Erosion of cartilage in DIPs and PIPs by erosive OA
Why can erosive OA be confused with RA
erosive OA is inflammatory
Erosive OA risk factors
Middle age / post menopausal
Female
Dyslipidaemia
Metabolic syndrome
